Insufficient Science About Added Sugar?

September 26, 2017

Story at-a-glance

A report reveals emails between former Coca-Cola executives and industry-funded front groups, detailing how food and beverage companies deliberately influence scientific evidence and public option

Several tactics were revealed, such as the food industry generating its own evidence by directly commissioning the work and using external organizations to do it for them

The industry seeks to influence scientific bodies and medical associations by seeking key leadership roles in such organizations and using their positions to direct debate and discussions in their favor

Allowing the junk food industry to participate in discussions related to nutrition and public health policy is counterproductive and not in the public’s best interest, yet it continues anyway

By Dr. Mercola

How much of a role does added sugar in the U.S. diet contribute to obesity and chronic disease? It depends on who you ask. Independent studies have linked the consumption of added sugar to everything from heart disease and depression to declines in brain function, kidney damage and diabetes.

The World Health Organization (WHO) recommended in 2015 that sugar should make up less than 10 percent of your total daily energy intake, with additional benefits to be had if you reduce it to below 5 percent (which amounts to about 25 grams, or 6 teaspoons of sugar a day).1 In contrast, according to the 2015 Dietary Guidelines for Americans, the average American consumes 17 teaspoons of sugar a day.2

The widespread prevalence of sugar in the U.S. diet is common knowledge — it’s added to the vast majority of processed foods, even those you may consider to be savory, like tomato sauce. Yet, the U.S. Dietary Guidelines only recommend limiting calories from added sugars to no more than 10 percent each day, or 12 teaspoons, for a 2,000-calorie diet.

If the Guidelines were truly put out to protect Americans’ health, it should be far lower and, in fact, the Dietary Guidelines Advisory Committee (DGAC) did recommend that Americans reduce their intake of sugar-sweetened foods and beverages. However, this was followed by a flurry of activity from industry groups who, using tobacco-industry tactics, attempted to sway the dietary debate in their favor.

‘Direct Evidence’ the Food Industry Seeks to Influence Science and Public Policy

Gary Ruskin, co-founder of nonprofit advocacy group U.S. Right to Know, published a report in Critical Public Health that reveals emails between former Coca-Cola executives and the industry-funded International Life Sciences Institute (ILSI), as well as a mass email sent by another industry-backed group, International Food Information Council Foundation (IFIC).3

The messages “appear to be the food industry’s roadmap for dealing with scientific challenges,” Ruskin told Bloomberg. “I’ve never seen such a document.”4 The analysis of the email exchange shows how food and beverage companies deliberately influence evidence and public option. According to the report:5

“The results provide direct evidence that senior leaders in the food industry advocate for a deliberate and coordinated approach to influencing scientific evidence and expert opinion.

The paper reveals industry strategies to use external organizations, including scientific bodies and medical associations, as tools to overcome the global scientific and regulatory challenges they face. This evidence highlights the deliberate approach used by the food industry to influence public policy and opinion in their favor.”

The exchange occurred like this: the day after DGAC’s report was released, IFIC sent out a mass email to its directors and staff detailing the call they’d had with the media earlier that morning, in which they discussed “insufficient evidence” behind the recommendation to reduce added sugars. More than 20 experts were apparently on hand to discuss the issues with the media. Bloomberg continued:6

“The email was then forwarded outside of the organization to Alex Malaspina, a former Coca-Cola executive and the founding president of ILSI. Malaspina, in turn, forwarded it to two current Coke executives, adding that ‘IFIC is coming through for our industry’ …

The next morning, in an email to Malaspina, Michael Ernest Knowles, a former vice president of Global Scientific and Regulatory Affairs at Coca-Cola and former president of ILSI, went further than media outreach, calling for ‘the generation of credible consensus science on the issues hitting the industry — obesity and causative factors, sugar, low/no calories sweetener safety — in particular we have to use external organizations in addition to any work we directly commission.’”

Already, a report sponsored by ILSI was published in the Annals of Internal Medicine, concluding “guidelines on dietary sugar do not meet criteria for trustworthy recommendations and are based on low-quality evidence” and suggesting public health officials be aware of this when making recommendations and consumers take it into account when making dietary choices.7,8

Industry Tactics to Shape Diet and Public Health-Related Issues Revealed

The email exchange was quite eye-opening in revealing how senior leaders in the food industry seek to influence science and public health recommendations. Several tactics were revealed, according to the Critical Public Health report, including:9

Influence on evidence generation and summation, such as the food industry generating its own evidence by directly commissioning the work and using external organizations to do so

Highlighting the limitations of non-industry sponsored research to raise doubts in science

Exerting influence over scientific bodies and medical associations by seeking key leadership roles in such organizations, and using their positions to direct debate and discussions in their favor

Using academic contacts to guide global debate and advocating “broad-based collaboration with government and key opinion leaders, and involvement in nutrition-related government reviews of the evidence base”

To sum up, the report highlights the fact that allowing the food industry to participate in discussions related to nutrition and public health is counterproductive and not in the public’s best interest:

“Companies that profit from the sale of unhealthy food have a clear conflict of interest in relation to NCD [non-communicable disease] prevention, and are unlikely to have the public’s health as a motivating factor … The tactics displayed by these food industry leaders to influence the scientific evidence base and global debate in relation to nutrition and food represent a substantial risk to efforts to address NCDs globally.

The public health and medical community need to be aware that they are viewed as tools through which food companies can overcome threats to their profits.”10

Coca-Cola Secretly Funded Journalism Conferences, Has Ties to CDC

In 2015, Coca-Cola was outed for secretly funding and supporting the Global Energy Balance Network, a nonprofit front group that promoted exercise as the solution to obesity while significantly downplaying the role of diet and sugary beverages in the weight loss equation.11 Public health authorities again accused the group of using tobacco-industry tactics to raise doubts about the health hazards of soda, and a letter signed by more than three dozen scientists said the group was spreading "scientific nonsense.”12

By December 2015, the Global Energy Balance Network announced it would be shutting down, with Coca-Cola claiming it was working on increased transparency. However, it’s since been revealed that the company funded a six-figure bill for a series of journalism conferences, which, the BMJ investigation reveals, “was more than repaid in favorable press coverage.” The report continued:13

“For drinks manufacturers such as Coca-Cola the idea that consuming their products is fine as long as you exercise — reinforced with expensive advertising campaigns associated with sport — has been an important one.

As Yoni Freedhoff, assistant professor of medicine at the University of Ottawa, told The BMJ, ‘For Coca-Cola the ‘energy balance’ message has been a crucial one to cultivate, as its underlying inference is that, even for soda drinkers, obesity is more a consequence of inactivity than it is of regularly drinking liquid candy.’”

The conferences were hosted at a university, which was not forthcoming about the source of the funding. However, Coca-Cola’s ties run even deeper than academia, all the way to the U.S. Centers for Disease Control and Prevention (CDC).

In 2016, Barbara Bowman, Ph.D., former director of the CDC's Division for Heart Disease and Stroke Prevention (DHDSP), left the agency unexpectedly, two days after her close ties with Coca-Cola were revealed. Bowman reportedly aided a Coca-Cola representative in efforts to influence WHO officials to relax recommendations on sugar limits.14

Bowman, however, was not the only CDC official looking out for Coca-Cola. Uncovered emails revealed that Michael Pratt, senior adviser for Global Health in the National Center for Chronic Disease Prevention and Health Promotion at the CDC, has also promoted and led research for the soda giant.15 Even the newly appointed CDC director, Dr. Brenda Fitzgerald, received $1 million in funding from Coca-Cola to combat childhood obesity during her six-year stint as commissioner of Georgia’s public health department.

Not surprisingly, her Coke-funded anti-obesity campaign focused on exercise. None of the recommendations involved cutting down on soda and junk food, yet research shows exercise cannot counteract the ill effects of a high-sugar diet.

Beyond their cozy ties with the CDC, Coca-Cola funds more than 90 different medical and health organizations,16 including the American Heart Association, the American Diabetes Association, the National Institutes for Health and the American Cancer Society. All of these organizations work on strategies to reduce incidence of disease, yet receive funding from a major purveyor of those very diseases.

For decades, the links between sugar and poor health outcomes have been buried and nutritional science has been misdirected on purpose — to shield industry interests, without regard for public health. In another example, a historical analysis of internal industry documents stated the link between sugar and coronary heart disease emerged in the 1950s but was buried by the sugar industry, which launched its own research aimed at shifting the blame toward dietary fats. As noted by the authors:17

"Early warning signals of the coronary heart disease (CHD) risk of sugar (sucrose) emerged in the 1950s. We examined Sugar Research Foundation (SRF) [now the Sugar Association] internal documents, historical reports and statements relevant to early debates about the dietary causes of CHD and assembled findings chronologically into a narrative case study …

[O]ur findings suggest the industry sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD. Policymaking committees should consider giving less weight to food industry–funded studies and include mechanistic and animal studies as well as studies appraising the effect of added sugars on multiple CHD biomarkers and disease development."

The Sugar Association fired back, stating that while they should have “exercised greater transparency” in its research activities, the digging up of a 50-year-old study amounted to using “headline-baiting articles to trump quality scientific research.”18 In an accompanying editorial, Marion Nestle, nutrition professor at New York University, put them in their place, summing it up quite succinctly:19

“This 50-year-old incident may seem like ancient history, but it is quite relevant, not least because it answers some questions germane to our current era. Is it really true that food companies deliberately set out to manipulate research in their favor? Yes, it is, and the practice continues.”

What Does the Science Really Say About Added Sugar?

If you listen to the industry fluff, you’ll come away believing that perhaps sugar isn’t so bad, especially if you exercise and make up for the “empty calories” by consuming some vegetables and skipping dessert. In reality, researchers have known since the 1960s that your body metabolizes different types of carbohydrates, like glucose and fructose, in different ways, causing very different hormonal and physiological responses that absolutely may influence fat accumulation and metabolism.20

Gary Taubes, co-founder of the Nutrition Science Initiative and the author of “The Case Against Sugar,” expertly documents sugar’s link to chronic disease and much more, including whether sugar should more aptly be described as a drug instead of a food. It doesn’t cause the immediate symptoms of intoxication, like dizziness, staggering, slurring of speech or euphoria, associated with other “drugs,” yet perhaps this only allowed its long-term medical consequences to go “unasked and unanswered.”

“Most of us today will never know if we suffer even subtle withdrawal symptoms from sugar, because we’ll never go long enough without it to find out,” Taubes wrote, adding that sugar has likely killed more people than tobacco, and that tobacco wouldn't have killed as many people as it did without sugar.21

Once you understand the health risks of sugar, including the fact that it’s not an issue of extra calories but the kind of calories, it may motivate you to want to cut back, or eliminate, this substance from your diet and that of your children. If a sugar craving strikes, fit in a quick workout, drink a cup of organic black coffee, or eat something sour (like fermented vegetables or lemon water), all of which are excellent at helping you kick the craving.

The Emotional Freedom Techniques (EFT) is another great option, which has been shown to significantly reduce food cravings and increased peoples’ ability to show restraint — even after six months.22 A video demonstration is below, but here is the basic approach, which you can start using right now:

Identify a food you crave by visualizing it or imagining you’re eating it

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